肝脏影像报告和数据系统治疗反应的阅片者间可靠性：一项系统评价和荟萃分析
Interreader Reliability of Liver Imaging Reporting and Data System Treatment Response: A Systematic Review and Meta-Analysis.
作者信息
Kim Dong Wook, Choi Sang Hyun, Lee Ji Sung, Kim So Yeon, Lee So Jung, Byun Jae Ho
机构信息
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.
Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 05505, Korea.
出版信息
Diagnostics (Basel). 2021 Feb 4;11(2):237. doi: 10.3390/diagnostics11020237.
BACKGROUND
For a proper management strategy in patients with locoregionally treated hepatocellular carcinoma (HCC), it is essential that the Liver Imaging Reporting and Data System (LI-RADS) treatment response algorithm (LR-TR) has high interreader reliability. We aimed to systematically evaluate the interreader reliability of LR-TR and sources of any study heterogeneity.
METHODS
Original studies reporting the interreader reliability of LR-TR were identified in MEDLINE and EMBASE up to 20 September 2020. The pooled kappa coefficient (κ) was calculated using the DerSimonian-Laird random effects model. Subgroup analyses were performed according to imaging modality (magnetic resonance imaging (MRI) or computed tomography (CT)). Meta-regression analyses were performed to explore study heterogeneity.
RESULTS
Eight studies with 851 HCCs were finally included. Pooled κ was 0.70 (95% CI, 0.58-0.82) for CT/MRI LR-TR, and those of MRI and CT were 0.71 (95% CI, 0.53-0.89) and 0.71 (95% CI, 0.65-0.78), respectively. Study design ( < 0.001) and type of treatment ( = 0.02) were significantly associated with substantial study heterogeneity.
CONCLUSION
LR-TR showed substantial interreader reliability regardless of the imaging modality. Because of substantial study heterogeneity, which was significantly associated with study design and type of treatment, published values for the interreader reliability of LR-TR should be interpreted with care.
背景
对于局部治疗的肝细胞癌（HCC）患者的合理管理策略，肝脏影像报告和数据系统（LI-RADS）治疗反应算法（LR-TR）具有较高的阅片者间可靠性至关重要。我们旨在系统评估LR-TR的阅片者间可靠性以及任何研究异质性的来源。
方法
截至2020年9月20日，在MEDLINE和EMBASE中检索报告LR-TR阅片者间可靠性的原始研究。使用DerSimonian-Laird随机效应模型计算合并kappa系数（κ）。根据成像方式（磁共振成像（MRI）或计算机断层扫描（CT））进行亚组分析。进行Meta回归分析以探索研究异质性。
结果
最终纳入8项研究，共851例HCC。CT/MRI的LR-TR合并κ为0.70（95%CI，0.58-0.82），MRI和CT的合并κ分别为0.71（95%CI，0.53-0.89）和0.71（95%CI，0.65-0.78）。研究设计（<0.001）和治疗类型（=0.02）与显著的研究异质性显著相关。
结论
无论成像方式如何，LR-TR均显示出较高的阅片者间可靠性。由于研究异质性较大，且与研究设计和治疗类型显著相关，因此LR-TR阅片者间可靠性的已发表值应谨慎解读。
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